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Heller myotomy

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https://www.readbyqxmd.com/read/28924729/dor-vs-toupet-fundoplication-after-laparoscopic-heller-myotomy-long-term-randomized-controlled-trial-evaluated-by-high-resolution-manometry
#1
Gonzalo Torres-Villalobos, Enrique Coss-Adame, Janette Furuzawa-Carballeda, Fernanda Romero-Hernández, Blanca Blancas-Breña, Samuel Torres-Landa, Axel Palacios-Ramírez, Edgar Alejandro-Medrano, Axel Hernández-Ávila, Athenea Flores-Najera, Lourdes Margarita Ávila Escobedo, Cecilia Ramírez Angulo, Angélica Rodríguez-Garcés, Miguel Ángel Valdovinos
BACKGROUND: Laparoscopic Heller myotomy (LHM) with partial fundoplication is an effective treatment for achalasia. However, the type of fundoplication is still a subject of debate. AIM: The aim of the study is to identify which partial fundoplication leads to better control of acid exposure, manometric parameters, and symptoms scores. METHODS: A randomized controlled trial was performed to compare Dor vs Toupet fundoplication after LHM. The preoperative diagnosis was made by high-resolution manometry (HRM), upper endoscopy, and barium esophagogram...
September 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28919276/-focus-on-achalasia
#2
Marie-Anne Guillaumot, Maximilien Barret, Sarah Leblanc, Mahaut Leconte, Bertrand Dousset, Ammar Oudjit, Frédéric Prat, Stanislas Chaussade
The pathophysiology of achalasia is largely unknown, and involves the destruction of ganglion cell in the esophageal myenteric plexus. High-resolution esophageal manometry is the key investigation. Endoscopic pneumodilatation and laparoscopic Heller myotomy have comparable short-term success rates, around 90%. The main complication after pneumodilatation is esophageal perforation, occurring in about 1% of cases. Peroral endoscopic myotomy is a promising treatment modality, however with frequent post-procedural gastroesophageal reflux...
September 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28867969/an-overview-of-achalasia-and-its-subtypes
#3
Dhyanesh A Patel, Brian M Lappas, Michael F Vaezi
Achalasia is one of the most studied esophageal motility disorders. However, the pathophysiology and reasons that patients develop achalasia are still unclear. Patients often present with dysphagia to solids and liquids, regurgitation, and varying degrees of weight loss. There is significant latency prior to diagnosis, which can have nutritional implications. The diagnosis is suspected based on clinical history and confirmed by esophageal high-resolution manometry testing. Esophagogastroduodenoscopy is necessary to rule out potential malignancy that can mimic achalasia...
July 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28839899/poem-and-the-management-of-achalasia
#4
Matthew Banks, Rami Sweis
Achalasia is a rare oesophageal motility disorder predominantly causing dysphagia and regurgitation of food and fluids. Diagnosis is made typically after a combination of tests including endoscopy, barium swallow and oesophageal manometry. The advent of high-resolution manometry has led to the Chicago Classification which divided achalasia into three types. This improved the understanding of presentation, prognosis and might also help tailor therapy. Botulinum toxin has been shown to have good, but short-term efficacy...
April 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28836246/-clinical-experience-of-combined-laparoscopic-endoscopic-heller-myotomy-and-modified-dor-fundoplication-for-cardiochalasia
#5
Xiaofang Qiao, Jinlong Li, Hua Xu, Xin Wan, Jiaming Zhu
OBJECTIVE: To investigate the efficacy of combined laparoscopic-endoscopic lower esophageal sphincterotomy and modified Dor fundoplication for cardiochalasia patients. METHODS: Clinical data of 11 cardiochalasia patients who underwent combined laparoscopic-endoscopic lower esophageal sphincterotomy and modified Dor fundoplication by the same medical team from January 2015 to December 2016 at The Second Hospital of Jilin University were retrospectively analyzed. The procedure was as follows: an incision was made in the anterior wall of esophagus and dissection of esophageal muscular layer was performed, then the bulged esophageal mucosa was covered by the fundus after 180 degrees fold to the right (fundoplication), finally the gastric fundus was joined to the right diaphragmatic foot by 3 to 5 knotted suture...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28815063/the-impact-of-flexible-endoscopy-in-esophageal-surgery
#6
REVIEW
Alejandro Nieponice, Fabio Nachman, Adolfo Badaloni, Franco Ciotola, Cecilia Zubieta, Mauricio Ramirez
Achalasia and Treatment of esophageal Adenocarcinoma are commonly associated to surgical resection. Newer technologies in interventional endoscopy gave way to a substantial paradigm shift in the management of these conditions. In the case of achalasia, endoscopic myotomy is rapidly displacing Heller's myotomy as the gold standard in many centers. Early stage neoplasia in Barrett's esophagus (BE) comprising high-grade dysplasia (HGD), intramucosal and, in some cases, submucosal carcinoma is now being treated without the need of esophagectomy...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28799145/a-third-myotomy-with-peroral-endoscopic-myotomy-after-two-failed-heller-myotomies
#7
Majidah Bukhari, Yamile Haito Chavez, Yen-I Chen, Olaya I Brewer Gutierrez, Mouen A Khashab
No abstract text is available yet for this article.
August 10, 2017: Endoscopy
https://www.readbyqxmd.com/read/28740664/development-of-a-novel-ex-vivo-porcine-laparoscopic-heller-myotomy-and-nissen-fundoplication-training-model-toronto-lap-nissen-simulator
#8
Hideki Ujiie, Tatsuya Kato, Hsin-Pei Hu, Patrycja Bauer, Priya Patel, Hironobu Wada, Daiyoon Lee, Kosuke Fujino, Colin Schieman, Andrew Pierre, Thomas K Waddell, Shaf Keshavjee, Gail E Darling, Kazuhiro Yasufuku
BACKGROUND: Surgical trainees are required to develop competency in a variety of laparoscopic operations. Developing laparoscopic technical skills can be difficult as there has been a decrease in the number of procedures performed. This study aims to develop an inexpensive and anatomically relevant model for training in laparoscopic foregut procedures. METHODS: An ex vivo, anatomic model of the human upper abdomen was developed using intact porcine esophagus, stomach, diaphragm and spleen...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28724307/per-oral-endoscopic-myotomy-poem-a-new-endoscopic-treatment-for-achalasia
#9
Pablo Miranda García, Fernando Casals Seoane, Jean-Michel Gonzalez, Marc Barthet, Cecilio Santander Vaquero
BACKGROUND/AIMS: Per-oral endoscopic myotomy (POEM) is a new minimally invasive technique to treat achalasia. METHODS: We performed a review of the literature of POEM with a special focus on technical details and the results obtained with this technique in patients with achalasia and other esophageal motility disorders. RESULTS: Thousands of POEM procedures have been performed worldwide since its introduction in 2008. The procedure is based on the creation of a mucosal entry point in the proximal esophagus to reach the cardia through a submucosal tunnel and then perform a myotomy of the muscular layers of the cardia, esophagogastric junction and distal esophagus, as performed in a Heller myotomy...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28717439/achalasia-current-therapeutic-options
#10
REVIEW
Zubin Arora, Prashanthi N Thota, Madhusudhan R Sanaka
Achalasia is a chronic incurable esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis. Although rare, it is currently the most common primary esophageal motility disorder, with an annual incidence of around 1.6 per 100,000 persons and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and weight loss. As the underlying etiology of achalasia remains unclear, there is currently no curative treatment for achalasia...
June 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/28711287/in-vivo-experience-with-poem-an-essential-activity-for-developing-the-technique-in-humans
#11
A Peñaloza-Ramírez, J Suárez-Correa, J Báez-Blanco, C Sabogal-Gómez, H Kuan-Casas, C Sánchez-Pignalosa, P Aponte-Ordóñez
INTRODUCTION AND OBJECTIVES: Achalasia is the most widely studied esophageal motility disorder. No treatment has achieved completely satisfactory results. The laparoscopic Heller esophagomyotomy is currently the most accepted technique. With the advent of minimally invasive surgery, the appearance of peroral endoscopic submucosal myotomy (POEM) has promising results. The primary aim of our study was to perform peroral endoscopic esophagomyotomy in animal experimentation models to perfect the technique and later apply it to humans...
July 12, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28702097/pediatric-achalasia-single-center-study-of-interventional-treatment
#12
Andrzej Grabowski, Wojciech Korlacki, Michał Pasierbek, Roksana Pułtorak, Filip Achtelik, Maciej Ilewicz
INTRODUCTION: Esophageal achalasia is a rare entity in children. However, young age is a factor of failure of conservative treatment, emphasizing the role of surgery. In our institution laparoscopic Heller's cardiomyotomy is the chosen procedure for surgical treatment. AIM: To assess the outcome of surgery for achalasia treatment in children operated on in a single institution. MATERIAL AND METHODS: A retrospective analysis of consecutive patient records from the years 1997 to 2014 was performed...
2017: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/28691186/per-oral-endoscopic-myotomy-poem-as-a-salvation-technique-post-heller-an-international-experience
#13
Amy Tyberg, Reem Z Sharaiha, Pietro Familiari, Guido Costamagna, Fernando Casas, Nikhil A Kumta, Maximilien Barret, Amit P Desai, Felice Schnoll-Sussman, Payal Saxena, Guadalupe Martínez, Felipe Zamarripa, Monica Gaidhane, Helga Bertani, Peter V Draganov, Valerio Balassone, Ahmed Sharata, Kevin Reavis, Lee Swanstrom, Martina Invernizzi, Stefan Seewald, Hitomi Minami, Haruhiro Inoue, Michel Kahaleh
BACKGROUND: The treatment for achalasia has traditionally been Heller myotomy (HM). Despite its excellent efficacy rate, a number of patients remain symptomatic post-procedure. Limited data exists as to the best management for recurrence of symptoms post HM. We present an international, multicenter experience evaluating the efficacy and safety of post-HM per-oral endoscopic myotomy (POEM). METHODS: Patients who underwent a POEM post-HM from 13 centers from January 2012 to January 2017 were included as part of a prospective registry...
July 10, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28686640/learning-curve-for-laparoscopic-heller-myotomy-and-dor-fundoplication-for-achalasia
#14
Fumiaki Yano, Nobuo Omura, Kazuto Tsuboi, Masato Hoshino, Seryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga
PURPOSE: Although laparoscopic Heller myotomy and Dor fundoplication (LHD) is widely performed to address achalasia, little is known about the learning curve for this technique. We assessed the learning curve for performing LHD. METHODS: Of the 514 cases with LHD performed between August 1994 and March 2016, the surgical outcomes of 463 cases were evaluated after excluding 50 cases with reduced port surgery and one case with the simultaneous performance of laparoscopic distal partial gastrectomy...
2017: PloS One
https://www.readbyqxmd.com/read/28664434/clinical-outcomes-five-years-after-poem-for-treatment-of-primary-esophageal-motility-disorders
#15
Ezra N Teitelbaum, Christy M Dunst, Kevin M Reavis, Ahmed M Sharata, Marc A Ward, Steven R DeMeester, Lee L Swanström
BACKGROUND: Peroral endoscopic myotomy (POEM) is a novel operation for the treatment of achalasia and other esophageal motility disorders. While POEM has shown excellent short-term safety and efficacy, the long-term symptomatic outcomes after the procedure are unknown. METHODS: Patients from a single center that underwent POEM for treatment of esophageal motility orders and were greater than 5 years removed from their operation were studied. Patients were contacted to assess current symptoms and encouraged to undergo repeat endoscopy for objective follow-up...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28660419/per-oral-endoscopic-myotomy-vs-laparoscopic-heller-myotomy-does-gastric-extension-length-matter
#16
Mauricio Ramirez, Cecilia Zubieta, Franco Ciotola, Alfredo Amenabar, Adolfo Badaloni, Fabio Nachman, Alejandro Nieponice
OBJECTIVE: To report our experience in POEM vs. LHM, with particular focus on myotomy extension. BACKGROUND: POEM has been adopted worldwide as a treatment for achalasia. While resolution of dysphagia is above 90%, postoperative reflux ranges from 10 to 57%. Myotomy length has been a controversial topic. METHODS: Thirty-five cases of POEM were prospectively analyzed and compared retrospectively to the last 35 patients that underwent LHM, from December 2010 to August 2016...
June 28, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28658680/submucosal-fibrosis-in-achalasia-patients-is-a-rare-cause-of-aborted-peroral-endoscopic-myotomy-procedures
#17
Qiu-Ning Wu, Xiao-Yue Xu, Xiao-Cen Zhang, Mei-Dong Xu, Yi-Qun Zhang, Wei-Feng Chen, Ming-Yan Cai, Wen-Zheng Qin, Jian-Wei Hu, Li-Qing Yao, Quan-Lin Li, Ping-Hong Zhou
Background and aims Peroral endoscopic myotomy (POEM) is now an established treatment for esophageal achalasia. The standard protocol ensures a smooth operation in most patients, but technical challenges and failures exist and little is known about the incidence, causes, and impact of aborted procedures. Here, using a large patient cohort, we attempted to answer these questions. Methods All patients admitted for planned POEM between August 2010 and July 2015 underwent chart review. Aborted POEM was defined as the inability to finish the procedure after submucosal injection...
August 2017: Endoscopy
https://www.readbyqxmd.com/read/28617881/is-heller-myotomy-better-than-balloon-dilation-a-meta-analysis
#18
Anita Illés, Nelli Farkas, Péter Hegyi, András Garami, Imre Szabó, Margit Solymár, Erika Pétervári, Márta Balaskó, Gabriella Pár, Patrícia Sarlós, Judit Bajor, Ákos Szűcs, József Czimmer, Kata Szemes, Áron Vincze
BACKGROUND AND AIM: Endoscopic balloon dilation (EBD) and laparoscopic Heller myotomy (LHM) are the most commonly performed treatment options for achalasia. Decision between these treatment options is difficult. The aim of this meta-analysis was to evaluate the efficacy of EBD compared to LHM. METHODS: The electronic databases PubMed, Embase and Cochrane Controlled Trials Registry were systematically searched for the period between January 1, 1976 and December 31, 2015...
June 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28617027/efficacy-of-peroral-endoscopic-myotomy-compared-with-other-invasive-treatment-options-for-the-different-esophageal-motor-disorders
#19
Fermín Estremera-Arévalo, Eduardo Albéniz, María Rullán, Irene Areste, Rosa Iglesias, Juan José Vila
INTRODUCTION: Peroral endoscopic myotomy (POEM) has been performed since 2008 on more than 5,000 patients. It has proven to be highly effective in the treatment of achalasia and has shown promising outcomes for other esophageal motility spastic disorders. METHODS: A literature review of the efficacy of POEM compared to the previous invasive treatments for different esophageal motility disorders was performed. The application in the pediatric and elderly populations and its role as a rescue therapy after other procedures are also outlined...
August 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28616407/peroral-endoscopic-myotomy-poem-for-treating-esophageal-motility-disorders
#20
REVIEW
Ian Wong, Simon Law
Pneumatic dilatation and Heller myotomy have been thoroughly studied as the most viable treatment options for achalasia. The pendulum, however, is shifting to the minimally invasive approach. Since Inoue et al. published the experience of the first 17 cases of peroral endoscopic myotomy (POEM) in 2010, there have been at least 5,000 cases performed worldwide and the number is increasing exponentially. Experts across the globe have been extending the indications to various esophageal motility disorders, to patients of extremes of age, sigmoidal esophagus and re-operated patients...
April 2017: Annals of Translational Medicine
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